A 28-year-old patient at 30 weeks gestation with twins reports her water has broken and she feels the urge to push. The nearest hospital is 40 minutes away and a helicopter is 45 minutes out. What is the most appropriate action?

Prepare for the Paramedic Readiness Exam 4 with our engaging quiz. Hone your skills with targeted questions, hints, and in-depth explanations. Excel on your exam with confidence!

When delivery could happen soon but definitive care is far away, the goal is to get the right obstetric and neonatal support together and arrange safe transport to a facility that can manage both mother and preterm baby. In this scenario, at 30 weeks with twins, ruptured membranes, and a strong urge to push, there’s a high risk of rapid delivery and complications. You’re 40 minutes from a hospital by ground and a helicopter isn’t immediately available, so the safest plan is to request additional resources now—bringing in obstetric expertise, neonatal resuscitation capability, and a team that can assist with transport. This ensures proper assessment, oversight, and equipment for potential delivery either en route or at the hospital, while avoiding an on-scene delivery or attempting a cesarean in a field setting, which isn’t feasible or safe.